Until the dawn: everyday experiences of people living with COVID-19 during the pandemic in Thailand

Theoretical perspective

The Roy adaptation model (RAM) serves as the theoretical framework for this study, deepening our understanding of the lived experiences and the impact of COVID-19 cases. The application of RAM in nursing research provides a structured yet flexible approach that enhances qualitative inquiry rather than limiting creativity. By offering a comprehensive model of adaptation, RAM enables researchers to interpret individuals’ responses holistically, allowing the study to capture diverse perspectives without imposing rigid constraints (Roy, 2009, 2011). While qualitative research thrives on open-ended exploration, RAM does not stifle creativity, but rather provides an adaptable analytical lens that supports thematic development. The model’s focus on focal, contextual, and residual stimuli aligns naturally with participants’ narratives, ensuring that emerging themes remain participant-driven while maintaining coherence and interpretative depth (Roy, 2009).

RAM (Roy, 2001, 2009, 2011) describes individuals as adaptive systems composed of interconnected elements that function as a unit, influenced by focal, contextual, and residual stimuli (Roy, 2009). These adaptive responses may result in positive adaptation (improved health and well-being) or maladaptation (prolonged distress and illness). In this study, RAM serves as a guiding framework to analyze how COVID-19 survivors navigate stress, stigma, and social reintegration, ensuring that mental health interventions are tailored to patients’ lived realities rather than predefined categories.

Additionally, our phenomenological-hermeneutic approach ensures that the interpretation of participants’ experiences remains unrestricted. The use of RAM does not predetermine findings, but rather strengthens thematic coherence, allowing multidimensional perspectives to emerge organically (Dayılar Candan, Dogan, Güler, & Carroll, 2022). By maintaining methodological flexibility, this study leverages RAM to enrich qualitative insights, ensuring that new discoveries can unfold while preserving the interpretative integrity of participant experiences.

Thus, rather than restricting exploration, RAM enhances the study’s depth, offering a structured yet adaptable framework that supports both theoretical rigor and the authenticity of lived experiences.

Design

This research employed Interpretative Phenomenological Analysis (IPA) to explore the lived experiences of COVID-19 survivors. IPA’s idiographic and interpretative stance allowed us to examine how individuals made sense of their illness and recovery experiences.

Participants

Fifteen participants were selected through purposeful sampling. As per the inclusion criteria, participants included COVID-19 survivors who had been discharged from the hospital and provided written consent for participation. COVID-19 cases that experienced stress or mental health problems were prevented from giving informed consent, and their participation was thus excluded.

Procedures

The phenomenological-hermeneutic approach was employed to explore and interpret the lived experiences and perceptions related to the COVID-19 pandemic (Al Kalaldeh et al., 2018; Graor & Knapik, 2013; Kvale & Brinkmann, 2014). To effectively capture the rich and nuanced perspectives of COVID-19 survivors, the research team developed semi-structured individual interview questions (Imkome & Moonchai, 2025), grounded in an extensive review of the literature focusing on adaptation and emotional responses. The question design was informed by previous research and structured around the Roy Adaptation Model (RAM), aiming to investigate how individuals navigated the psychological, social, and economic challenges posed by the pandemic.

The RAM provided a flexible yet systematic framework for formulating interview questions, enabling the exploration of focal, contextual, and residual stimuli—elements crucial for understanding the adaptation process (Roy, 2009, 2011). This approach allowed participants to freely express their experiences beyond predefined categories, offering deeper insights into their coping mechanisms and psychosocial responses.

To ensure content validity, the interview guide was critically reviewed by three expert validators specializing in phenomenology and adaptation theory. Their evaluations confirmed that the questions maintained conceptual integrity, remained open-ended, and facilitated authentic narratives from participants.

The interview questions were meticulously aligned with key principles of the Roy Adaptation Model (RAM). For example, questions such as “How have you coped with the impacts of the COVID-19 outbreak on yourself, your family, and your community?” and “Who or what groups have helped you alleviate stress, and in what ways?” were designed to examine adaptation across physiological, self-concept, role-function, and interdependence domains, consistent with RAM’s core constructs.

Data collection

Participants were recruited through the nursing offices of a hospital located in a different region of Thailand. Initially, their willingness to participate was assessed via phone calls, after which nurses provided comprehensive information regarding the interview process. Video interviews were conducted via Microsoft Teams at times convenient for participants, following a thorough explanation of the research objectives and the acquisition of both verbal and written informed consent.

The sampling process continued until data saturation was reached, defined as the point at which no new themes emerged. To uphold professionalism and ethical integrity, all interviews were conducted by the researcher, a psychiatric nurse, ensuring a neutral yet supportive environment for participants. Interview durations varied from 25 to 60 minutes, with strict adherence to data anonymization procedures. In the final step, transcripts were returned to participants for their review and corrections, ensuring accuracy and validation of their narratives.

Ethical approval

This project was approved by the Human Research Ethics Committee of Thammasat University (Science), Thailand (COA No. 119/2563). The research adhered to ethical standards established by the Institutional Review Board (IRB) and the Helsinki Declaration (2000). Prior to obtaining informed consent, all participants were informed about the study’s objectives, the safe protection of their data, and the associated risks and benefits. Participants were made aware of their right to withdraw from the study at any time.

Written informed consent was obtained from all participants before data collection commenced. Participation in the study was entirely voluntary, and the anonymity of participants was maintained throughout the research process. Confidentiality strategies were implemented, and identifying codes were assigned to the initial data collected from observations, interviews, and documentary analyses; access to this data was restricted to the research team.

The data were securely stored on the principal investigator’s password-protected computer until the conclusion of the study. After 24 months, all files were permanently deleted using “Secure Deletion Shredder,” a protected deletion program for Windows.

Consent

The research scope, risks, and benefits were explained to the participants; they were assured that anonymity and confidentiality would be maintained. They were informed that their participation in the research was voluntary (Imkome & Moonchai, 2022). We confirm that we obtained written and verbal consent to use data from the participants included in this study. The interview duration was determined based on the participants’ preferences, patience, and experiences. All interviews were recorded on video via Microsoft Teams of Thammasat University as a host and confidentially. The system automatically deletes data after recording for a month. The record was kept for a year for data checking and reference. Then, the computer of the researcher deleted the data and format.

Data analysis

Interviews and data analysis were conducted simultaneously using the IPA approach (Smith & Osborn, 2015; Alase, 2017). IPA emphasizes the in-depth examination of how individuals make sense of their lived experiences, with an idiographic focus that prioritizes detailed case-by-case analysis before identifying cross-case themes.

The analysis proceeded in several iterative stages. Initially, each transcript was read multiple times to foster immersion in the participant’s account, with exploratory notes capturing descriptive, linguistic, and conceptual comments. Emergent themes were then developed for each case, staying grounded in the participants’ words while interpreting their meaning-making processes. Following individual case analysis, the research team identified patterns across cases, leading to the development of superordinate themes that reflected both convergence and divergence in experiences.

The process was informed by the double hermeneutic: participants made sense of their experiences, and the researchers, in turn, interpreted those sense-making processes. To support interpretative depth, the Roy Adaptation Model (RAM) was subsequently employed as a theoretical lens to enrich the analysis, providing structure for interpreting participants’ adaptive responses across physiological, self-concept, role function, and interdependence domains (Roy, 2011).

Throughout the analysis, methodological rigor was maintained through bracketing, researcher reflexivity, and analytic memos. Interpretative decisions were discussed in peer debriefing sessions, and member checks were conducted by inviting participants to review their transcript summaries. All interpretations were managed manually to remain close to the data; use of SPSS Modeler has been removed for consistency with IPA’s qualitative orientation.

Trustworthiness of the study

This study adopted Interpretative Phenomenological Analysis (IPA) to explore the lived experiences of COVID-19 survivors, ensuring that participants’ perspectives and adaptive responses were interpreted through a structured yet flexible analytic framework. The integration of the Roy Adaptation Model (RAM) as a theoretical lens further enhanced interpretative depth by contextualizing adaptation within clearly defined psychosocial dimensions.

To ensure trustworthiness, we adhered to IPA-relevant quality indicators—sensitivity to context, commitment and rigor, transparency and coherence, and impact and importance—as recommended by Smith et al. (2022). Additionally, we maintained alignment with broader qualitative validity markers through the following strategies:

1. Credibility: Rapport was actively cultivated through empathetic interviewing by the lead researcher, a psychiatric nurse trained in therapeutic communication. Participant validation (member checks) was conducted by returning transcript summaries for feedback, enhancing the accuracy of lived experience representation.

2. Transferability: Rich contextual descriptions were embedded throughout the analysis, enabling readers to assess the relevance of findings to other clinical and cultural contexts. Although not generalizable, the idiographic detail strengthens interpretive applicability to similar public health settings.

3. Dependability: Peer debriefing was embedded across data collection and analysis phases. Weekly review sessions facilitated collaborative scrutiny of emerging themes, while monthly analytic reviews supported reflexive iteration.

Researcher triangulation was conducted via independent transcript analysis using IPA procedures (Smith & Osborn, 2015; Alase, 2017). Interpretative consistency was reviewed through cross-comparison of coding logs and theme structures. The analysis unfolded through three interrelated levels:

4. Confirmability

This dual-layered approach—anchoring interpretation in IPA while integrating RAM—allowed us to remain grounded in participants’ narratives while offering theoretical coherence in mapping adaptation processes. Methodological rigor was upheld through bracketing, triangulated coding, and validation checks, ensuring that findings were both credible and analytically rich.

Level 1: Participants’ demographic data and their self-understanding

Out of the 15 participants, 11.33% were unemployed, and 62.5% reported insufficient monthly family income (Table 1). During the interviews, all participants exhibited signs of physical survival; however, they demonstrated low levels of psychological integrity, manifesting as stress, fear, anxiety, communication difficulties, sleep disturbances, and impaired decision-making. Some participants were either unemployed or had recently lost their jobs. Nevertheless, they received social support from family, friends, and healthcare providers.

The data analysis revealed four key themes (see Figure 1). Respondents’ self-understanding at Level 1 underscores their immediate psychological, emotional, and social responses to the challenges posed by COVID-19. The findings indicate that participants experienced significant distress, characterized by heightened levels of stress, fear, anxiety, sleep disturbances, and difficulties in decision-making. Economic instability and job loss further exacerbated these challenges, leading to increased uncertainty about their futures.

Figure 1. Themes of the study.

Despite these adversities, participants demonstrated adaptive coping mechanisms, largely supported by their social networks. Their narratives highlighted a dynamic process of self-awareness: some individuals recognized their personal resilience, while others contended with stigma and feelings of isolation. The data further emphasize the vital role of social support in alleviating emotional strain, contributing to a more stable psychological state for those who actively sought help.

These findings offer valuable insights into how individuals perceived and processed their experiences, underscoring the necessity for psychosocial interventions aimed at fostering resilience and facilitating reintegration into society.

Level 2: Structural understanding

The lived experiences of participants following COVID-19 infection revealed a rich tapestry of meaning centered on survival, adaptation, and redefinition of self within a disrupted social and economic landscape. The following superordinate themes emerged from idiographic analysis: Stress, Economic and Social Impact, Social Stigma, Social Support, and Finding Meaning in Misfortune. While each participant’s narrative was unique, the following interpretative synthesis highlights both convergences and points of divergence across cases ( Figure 1).

Stress

In this context, stress refers to how people with COVID-19 perceive the infection and related circumstances as threatening and challenging to manage.

Participants described psychological strain stemming from uncertainty, fear of deterioration, and prolonged isolation. These experiences were not merely discomforting but symbolized existential vulnerability and the erosion of perceived safety.

“It is stressful to be alone in the room. It was not easy to go out and find food. The city was locked down; what would happen next? Will our family be okay? Will the people who live in the community hate us?” (Cl. 1)

“Going to the hospital, I coughed a lot the first day and felt stressed, and I did not feel better on the third day. The doctor from the hospital called to check my signs and symptoms, and I felt like I would not survive. After being admitted to the hospital, I was completely unconscious for about 40 days.” (Cl. 9)

“Covid infection affects health and causes stress.” (Cl. 15)

Economic and social impact

The economic and social impact here refers to the physical, mental, social, spiritual, and economic situations that people living with COVID-19 experience that affect their daily lives.

COVID-19’s ripple effects extended beyond the body, challenging participants’ economic security and social position.

“When there was no job, there was no money. I kept saving money until I could not manage it. Shops were closed, so it was not easy to buy food. My salary was reduced when I returned to work because we were expected to help the company financially. Our expenditures remained the same, but our incomes were smaller.” (Cl. 1)

“Maybe there are robbers and thieves because they do not have a choice. The whole problem lies in economic and mental health.” (Cl. 3)

“A stupid economy. If we get infected, we cannot work; it affects our family.” (Cl. 5)

“In health, stress, or unemployment, I have no money to spend like this.” (Cl. 6)

“COVID-19 is affecting work. I closed shop; cannot open now; no money.” (Cl. 13)

“I am unemployed, and I have no money.” (Cl. 15)

Social stigma

In this study, social stigma refers to how people with COVID-19 are stereotyped and treated with discrimination, dissociation, and loss of certain status due to association with a perceived disease.

Several narratives reflected a painful reconfiguration of social identity as participants were treated with suspicion, exclusion, or fear.

“It is stressful that people around you have to be poorly judged by society, such as when someone was evicted from their condo when it was learned that he had infected a friend with COVID-19 even though he had a young child. Some people know that it is my friend in the condo. So many people push them away from their homes. I told him to go elsewhere for 14 days and then return.” (Cl. 5)

“An infected friend posted a picture on Facebook. There will be a team to hunt him. This is a true story.” (Cl. 5)

“My mother gave them a gift and they returned it as if afraid it was infected with COVID-19.” (Cl. 8)

“I had to stop work. I had to take a break from work first. It was too bad. My friend is a football coach, and he has COVID-19. Parents do not let their children learn football from him. The room was locked when he returned to his condo; the owner had kicked him out.” (Cl. 11)

“You will be stigmatized by society as an infected person. Let us go together and not live in a normal society.” (Cl. 13).

Social support

In various fields, social support involves purposeful interactions that bring about help. For those infected with COVID-19, cultivating concrete and abstract assistance, such as recognizing, understanding, and responding to emotions, providing information, giving objects, and being accepted as part of the group, affects how a person perceives social support. Individuals are perceived as being loved, cared for, valued, and positively affected by their physical and mental health. This enables a person to face life-threatening events more effectively.

“I call home every day, and I jog to my room to watch television.” (Cl. 2)

“During stressful times, listening to music, reciting the prayers, doing housework, and watching TV with my girlfriend can relieve stress.” (Cl. 4)

“I was infected, and therefore [my] friends were exposed. They only have sympathy for us. We called to apologize. He said hey, it is okay. You can take care of yourself. It is not a problem. He wanted to encourage us and not make us more stressed.” (Cl. 5)

“I have a neighbor who acts as if she is his older sister and consults about dealing with COVID-19.” (Cl. 6)

“Luckily, most people are encouraging, and those around sick people are worried. They will never bully or scold.” (Cl. 1)

“When stressed, I listen to music and watch TV.” (Cl. 4)

“Doctor and his teams were highly qualified, and people received good treatment; they felt confident, and their health status gradually improved.” (Cl. 1)

“The health team from the hospital that has taken care of me since I was discharged still contacts me to ask about my symptoms, invite me to work, become a lecturer, and sometimes get a job. Recently, the agency made an appointment for an interview. If anything could help, such as providing information about COVID-19 or others, I would be happy to help. The hospital produces an application called Clinical App to track the symptoms of COVID-19 patients. So we do not have to go to the hospital. You can ask for advice in the app. There will be a team that takes care of coordinating.” (Cl. 1)

“Bang Khae Health Center contacted and coordinated care such as home visits and consults. They gave good help.” (Cl. 2)

“During the treatment, the medical team was excellent and did not show disgust. The doctors and nurses took good care of the patients, spoke well, cared for them, and encouraged them. They gave us medicines, checked the temperature and pressure, and always called to tell us. They provided detailed treatment care. The medical team is perfect.” (Cl. 4)

“At that time, I was in an intensive care unit. The healthcare team provided a PPE gown. All the care and treatment procedure was done quickly so that I could get out of the intensive care unit faster.” (Cl. 5)

“I was very well taken care of. The doctor would video call and ask about my condition. Then, a doctor would check the fever in the morning and evening. Everything about the food was good. I got lung x-rays, and they took blood samples. When I came out of the hospital, I called to ask, but I did not come to visit because it was difficult. After all, I was staying at work—I called to ask.” (Cl. 6)

“When my symptoms improved and I woke up in the hospital, the doctor took good care and was friendly.” (Cl. 9)

“The healthcare team at the Tambon health-promoting hospital providing care is outstanding, so I call and ask about health issues when I get any problem. They support me when I get a problem by providing information and medicine.” (Cl. 10)

“During the hospital stay, we would talk on the phone. He would call to check the fever, check here and there, and check every time there was a headache and fever. Ask how we were feeling. Check in the morning and at noon. If we had a fever, we called via Line and told him. There was a blood test and heart rate measurement. Since I coughed a lot, I had many medicines but no side effects. As soon as it got into my lungs, I suffered for 4–5 days, but now my lungs are normal, and I only had medication.” (Cl. 14)

“I wish there were a cure for the disease. It is essential for life because it is not only in Thailand; it is worldwide, and I want it to be researched quickly.” (Cl. 11)

“At first, I was worried because it was a new case. I do not know what the symptoms of COVID-19 are. Believing in the craftsmanship of Thai doctors and their teams, I felt that it was not scary, and I was fortunate to be taken care of by a hospital that felt that it was a leading hospital, so I was not worried.” (Cl. 1)

Finding Meaning in Misfortune

Finding Meaning in Misfortune means several participants reinterpreted their suffering as a source of growth or insight. This re-narration illustrates cognitive reframing—a psychological and spiritual coping strategy. Being infected was not merely endured; it became an opportunity for contribution and reflection.

“It was good luck in bad luck. We felt lucky because we could not find an experience like this. Advertising for life insurance companies and interviews with other agencies, including this interview and conducted research, is something that other people cannot do because they have not been infected. I am fortunate in the misfortunes that I have to face in this life.” (Cl. 1)

“When I found out that I was infected, I felt unlucky. There was a feeling of ’why so unlucky.’ But I was lucky enough to enter the treatment process until finally recovering and going out to live a normal life. I think that COVID-19 also brings good things, such as getting to know the medical system in Thailand. There is a line between the patient group and doctors in the medical personnel and equipment system. I will ask a lot because I want to know and check it out on Facebook. We will ask and check with the doctor. After getting the information, try to share it on Facebook with some friends. This infection was helpful. It is not just a punishment. It allows us to spread good things and benefit others after we are infected with COVID-19. We are lucky to be able to benefit society.” (Cl. 5)

Level 3: Theoretical interpretation

Adaptation is a concept that has been used to realize participants’ experiences, and further illumination can be gained through the Roy adaptation model (Roy, 2001, 2009). Based on this model, the participants’ stress, economic and social impact, social stigma, social support, and a sense that finding meaning in misfortune can be interpreted.

This model is based on the four dimensions as the person submitted to a scheme, including the stimulus, which generates the coping mechanisms and results that make up the individual, family, and community response. This scheme focuses on three stimulus types: 1) focal stimuli, which require stimulation, including fatigue, dyspnea, high fever, and cough, i.e., the signs and symptoms of COVID-19; 2) contextual stimuli, which can be defined as comorbidities; and 3) residual stimuli, which are described as internal and external factors, such as stress from unemployment, viral infodemic, financial problems, social stigma, and lack of appropriate Personal Protective Equipment (PPE).

Adaptative behavior is assessed in four modes: physiological, self-concept, role function, and interdependence. Additionally, the subdivided models are regulators, including the physiological mode, which we describe as the situation and function of people infected by COVID-19. This is pertinent since the body’s homeostasis is directly related to the lower probability of worsening symptoms. Secondly, the cognate coping mechanisms are self-concept, role function, and interdependence. The self-concept mode defines coping and highlights psychological and spiritual aspects. Indeed, considering the context of stress generated by this pandemic, asking for emotional support in chaotic times eases anguish and favors psychological well-being. The coping mechanism that complements the role function mode refers to the individual’s ability to understand their role in the world and the self-knowledge of their role in society. During the pandemic, this acknowledgment is necessary because the population does not participate in essential services; instead, it supports control measures when it fulfills social isolation measures such as visiting the hospital after an appointment.

In contrast, in the scope of essential services, health professionals, for example, legitimize their functional importance when they perform their duty with technical skills and humanity. The coping mechanism of the interdependence mode includes the affective demands of everyone. In fact, with a social distancing policy, it is common to observe anguish in the community, which has a particular need related to complete well-being. However, information and communication technologies can be alternatives to increasing physical distancing and its repercussions on the population’s biopsychosocial health. For the interdependence mode, social support from family and multidisciplinary treatment teams can decrease the experience of fear around the transmission and conditions related to COVID-19. Social stigma increases the participants’ stress, which increases the severity of COVID-19 (Sing Joo et al., 2021).

In conclusion, the theoretical interpretation of COVID-19 case perceptions showed that participants experienced stress, economic and social impact, stigma, and social support during the global COVID-19 pandemic. The participants’ adaptive process promoted their mental integrity and positively affected their health. Nonetheless, they discussed their existential perceptions during the interviews, raising questions about work and the future during crises. Knowledge gathered from this point of view will help plan to fight such crises in the future.

Stressful experiences in life caused by the COVID-19 pandemic

People with COVID-19 were stressed by being in lockdown and quarantined. Difficulty finding food sources and disgust from the community exacerbated the symptoms of the disease.

Social stigma toward people with COVID-19 existed among people such as relatives or neighbors who feared infection. People with COVID-19 were severely judged by society and experienced situations such as being hunted by a group of citizens who came to find them, who then publicized infection information, meaning that there was no safe place in society. The owners locked rooms and stopped renting to patients. Patients were kicked out of their place (Tsai & Wilson, 2020) and were insulted and bullied. Anyone who had an infected friend was stigmatized by society, meaning they could not stay together and not live in a typical community. Shreyaswi & Shashwath (2020) reported that reducing stigma and providing mental health services is a necessary public health response to COVID-19. Challenges related to the spread of COVID-19, stigma, and discrimination can affect patients diagnosed with COVID-19 and those who are quarantined. Effective communication is both accurate and timely. It positively affects coordination and community involvement and is a cornerstone for reducing stigma and promoting mental health. Besides, an integrated psychosocial rehabilitation program to reduce social stigma and improve the resilience of COVID-19 patients is needed (Son et al., 2021). While several steps are required to address stigma and promote mental health, a clear strategy to integrate mental health services into meeting public healthcare needs becomes necessary during the pandemic; for example, elaborating on possibilities to deliver mental health care through technology.

Additionally, participants mentioned the impact of stigmatization and discriminatory experiences on physical and psychological health during the pandemic. This situation has increased discrimination against East and Southeast Asians, with reports of anti-Asian harassment and attacks rising globally (Lee & Waters, 2021; Chen et al., 2020; Dhanani & Franz, 2020; Hahm et al., 2021; Noel, 2020).

Among those infected with COVID-19, social support was received during the COVID-19 outbreak, including treatment and assistance, information, and material provisions. For example, the landlord and neighbors showed no disgust when accepted as a part of society. Receiving love, care, appreciation, and acceptance from friends and family, such as encouraging calls during treatment, friends that did not mind doing activities with family members, such as exercising, listening to music, or watching TV, and consulting trusted people, such as a family member, and a health team that provided good care was also experienced. Hospitals produced an app called Clinical App to track the symptoms of COVID-19 patients, coordinate care, ask questions, help people receive care at home, and give advice; on this app, the medical team was beneficial and did not show disgust. Nurses took good care of the patient, unconditioned positive regards of care, encouraged (Galehdar et al., 2020a), (Galehdar et al., 2020b) and made video calls to ask about patients’ symptoms. Nurses checked their temperature in the morning and evening. Lung X-rays were obtained. A study by Rathnayake et al. (2021) examined nurses’ perspectives on caring for COVID-19 patients; their phenomenological study found that nurses were willing to provide care for COVID-19 patients because it was their duty and responsibility as well as a humanitarian issue. In the beginning, infected people always thought they were unlucky because of the infection’s severe economic, social, health, and mental impacts. However, after entering a good treatment regimen, symptoms improved, and they found themselves fortunate to be cured of this disease. Many established friendships with the health team. They acquired good morale and the ability to educate and share experiences during treatment to benefit society.

Impact of the COVID-19 pandemic

People were unhappy during the COVID-19 lockdown. The physical, mental, social, spiritual, and economic impacts experienced by people with COVID-19 affected their daily lives, such as having no job and using their savings instead of their salary. Unbalanced trade led to more robbers and thieves and increased stress and depression (Joo et al., 2021). This is consistent with a study by Hertz-Palmor et al. (2021) that examined the relationship between income loss, financial strain, and depressive symptoms during COVID-19. Moreover, according to research by Lei et al. (2020), stress during COVID-19 impacted the participants, and individuals with no psychosocial support were highly vulnerable to anxiety and depression during this pandemic (Hossain et al., 2020). Moreover, Nicola and research teams (Nicola et al., 2020a) (Nicola et al., 2020b) reported that social support was associated with a lower risk of mental health problems and correlated with another study of emotion regulation growth during the pandemic (Cuan-Baltazar et al. 2020; Dhanani, & Franz, 2020). Post-traumatic growth, psychological conditions, and both hopeless and post-stress growth were reported during the COVID-19 pandemic (Qi & Sheng, 2022; Gutiérrez-Cobo et al., 2021; Hu et al., 2021).

Limitations

The interview was conducted during community quarantine and after the participant was discharged from the hospital. The participants may have had stress and anxiety about their health status, long COVID, work, and economic problems; this may have prevented the authors from fully understanding the studied phenomena. In addition, the research consisted of a homogenous population of only 15 participants. Thus, a similar study that included these participants might have revealed different perceptions of experiences. The small sample size also increased the risk of bias.

Implications for nursing and health

Policy implications

Nursing interventions

Nursing research